Videomanometric analysis of supraglottic swallow, effortful swallow, and chin tuck in healthy volunteers
Videomanometric analysis of supraglottic swallow, effortful swallow, and chin tuck in healthy volunteers
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DOI：
10.1007/pl00009589
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发表时间：
1999-03-01
期刊：
影响因子：
2.6
通讯作者：
Ekberg, O
中科院分区：
文献类型：
--
作者：
Bülow, M;Olsson, R;Ekberg, O
对8名无吞咽问题的健康志愿者（4名女性，4名男性;年龄范围25-64岁，平均年龄41岁）同时进行视频放射摄影和固态测压（视频测压）。测试了三种不同的吞咽技术：声门上吞咽、用力吞咽和缩下巴。分析了7个影像学变量和6个测压变量。声门上吞咽技术与对照组吞咽技术无显著差异。由于舌骨和喉的抬高，用力吞咽显著（p = 0.0001）减少了舌骨-下颌骨距离，这导致吞咽期间舌骨最大运动显著（p = 0.007）减少，喉抬高显著（p = 0.009）减少。缩颏吞咽显著（p = 0.001）缩短了喉舌骨距离，也显著（p = 0.004）缩短了舌骨-下颌骨距离。缩颏吞咽也显示出显著（p = 0.003）较弱的咽部收缩。视频测压允许分析团输运、解剖结构的运动和测量管腔内压力。这些变量在评估吞咽技术时很重要。在本研究中，我们做了一些以前从未报道过的观察。当健康志愿者进行声门上吞咽时，他们执行的技术略有不同。因此，我们认为吞咽困难患者需要一段时间的训练才能有效地执行技术。缩颏术对咽缩肌功能不强的吞咽困难患者的气道保护功能有一定的影响。
Simultaneous videoradiography and solid-state manometry (videomanometry) was applied in eight healthy volunteers (four women, four men; age range 25-64 years, mean age 41 years) without swallowing problems. Three different swallowing techniques were tested; supraglottic swallow, effortful swallow, and chin tuck. Seven videoradiographic variables and six manometric variables were analyzed. The supraglottic swallowing technique did not differ significantly from that of the control swallows. The effortful swallow had a significantly (p = 0.0001) reduced hyoid-mandibular distance preswallow due to an elevation of the hyoid and the larynx, which caused a significantly (p = 0.007) reduced maximal hyoid movement and a significantly (p = 0.009) reduced laryngeal elevation during swallow. The chin tuck swallow had a significantly (p = 0.001) reduced laryngohyoid distance and also a significantly (p = 0.004) reduced hyoid-mandibular distance. The chin tuck swallow also displayed significantly (p = 0.003) weaker pharyngeal contractions. Videomanometry allows for analysis of bolus transport, movement of anatomical structures, and measurement of intraluminal pressures. These variables are important when evaluating swallowing techniques. In the present study, we made a few observations that never have been reported before. When healthy volunteers performed supraglottic swallow, they performed the technique somewhat differently. Therefore, we assume dysphagic patients would need a substantial period of training to perform a technique efficiently. Chin tuck could impair protection of the airways in dysphagic patients with weak pharyngeal constrictor muscles.